Real Estate Transfer Declaration Form (Page 6 of 8) in pdf

Real Estate Transfer Declaration Form Page 6

CITY OF HARVEY

15320 BROADWAY AVENUE

HARVEY, IL 60426

BUYER’S VERIFICATION

BUYER’S NAME: _________________________________________________________

CO-BUYER’S NAME: _____________________________________________________

PROPERTY ADDRESS: ___________________________________________________

___________________________________________________

CURRENT ADDRESS: ___________________________________________________

___________________________________________________

BUYER’S PHONE: ____________________________ WK: ______________________

CO- BUYER’S PHONE: ________________________WK: ______________________

EMPLOYER: _________________________________________________________

ADDRESS: ___________________________________________________________

EMPLOYER: _________________________________________________________

ADDRESS: ___________________________________________________________

I hereby certify that the above statements are true and correct.

BUYER’S NAME: ____________________________________DATE: _________________

CO-BUYER’S NAME: ________________________________ DATE: _________________

Subscribed to and sworn before me

A NOTARY PUBLIC this ___________________ day of ____________________, 20____.

___________________________________________________

NOTARY PUBLIC

City of Harvey Transfer Stamp Requirements-9/06

Real Estate Transfer Declaration Form Page 6